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Biomedical subjects

R H Moore

Publications and source records attributed to R H Moore.

At least 127 records · Page 7Linked to original sources
PubMed1977

Differentiation of transiently ischemic from infarcted myocardium by serial imaging after a single dose of thallium-201.

Myocardial 201Tl uptake and regional blood flow by the microsphere technique were determined in anesthetized dogs undergoing either 20 min of coronary occlusion and 100 min of reperfusion (N = 10) or 120 min of occlusion (N = 4). In both groups, 201Tl was injected intravenously after 10 min of occlusion. In transiently occluded dogs, regional flow at the time of 201Tl administration was reduced to 8 +/- 3% of normal flow in endocardial layers of the central ischemic zone. After 100 min of reperfusion, flow values were not significantly different from normal. 201Tl activity after reperfusion rose to 56 +/- 5% of normal, demonstrating that redistribution of the radionuclide occurred during the reflow period. In animals with persistent occlusion, there was a significant relationship between 201Tl uptake and flow (r = 0.95) and no evidence of redistribution of 201Tl during the two hour occlusion period. In another five dogs receiving 201Tl, serial gamma camera images obtained during reperfusion showed increasing uptake of the tracer in apical defects which returned to normal by 4 hours of reflow. Thirteen patients with stable angina received 2 mCi of 201Tl intravenously at peak exercise, and multiple gamma camera images obtained serially. All demonstrated zones of diminished 201Tl uptake 10 min after exercise. Defects which partially or completely disappeared within 1-6 hours postexercise corresponded to areas supplied by coronary arteries with significant stenoses. Persistent defects were present in regions of old myocardial infarction. Six additional patients with acute myocardial infarction demonstrated 201Tl myocardial defects which showed no significant change over 6 hours. Thus, redistribution of 201Tl into ischemic myocardium was demonstrated during transient coronary occlusion in dogs and after exercise stress in man. Sequential imaging after a single dose of 201Tl at the time of exercise may provide a means for distinguishing between transient perfusion abnormalities or ischemia and myocardial infarction of scar.

Acute Disease↗
PubMed1977

A clinicopathologic study of prognostic factors in cutaneous malignant melanoma.

Sex, size of the primary lesion, level of invasion at the primary site, clinical status of the regional lymph nodes at the time of diagnosis and whether or not the lymphatic or the blood vessels at the primary site were invaded by tumor cells are the prognostic factors found to influence the survival of patients with a cutaneous malignant melanoma. The last two factors were found to correlate with the level of invasion. Because of the high incidence of local recurrences after a small local excision, wide excision at the primary site of skin, subcutaneous tissue and fascia with skin graft should be the treatment of choice. The role of elective regional lymphadenectomy has to be questioned, as 51 per cent of the patients never required lymphadenectomy during the course of the disease, The higher incidence of satellitosis after such a procedure, elective lymph node dissection did not improve the survival. Therefore, it appears that regional lymph node dissection has a prognostic, rather than a therapeutic, role. From the time of the recurrence, it is clear that patients with systemic metastasis have the poorest prognosis. On the other hand, patients in whom satellitosis developed lived longer, but this was not statistically significant when compared with the survival of patients with a local recurrence or with regional lymph node metastasis; Early diagnosis should be emphasized because the two main factors that seem to influence survival are the depth of invasion and the size of the primary lesion. Finally, because the level of invasion and the status of the lymphatics and blood vessels seem to carry a high prognostic significance, each primary lesion should be examined pathologically with regard to these factors.

Adult↗
PubMed1977

Accuracy of roentgenograms of the chest in metastases to the lungs.

The findings on roentgenographic and tomographic examination of the chest were compared in 63 instances of suspected pulmonary metastases. These were further compared with the findings at thoracotomy in 41 instances. Of the 60 patients, 30 had soft tissue or bone sarcomas and 30 had carcinomas arising from colon, ovary or breast, and it also included five with malignant melanoma. Three patients with sarcomas had more than one thoracotomy. The diagnosis of pulmonary metastases by roentgenography of the chest was correct in 60 of 63 instances. Tomograms showed more lesions in 14 of 33 instances of sarcomas and 14 of 30 instances of carcinomas. Thoracotomy revealed even more lesions than were detected by tomography in 21 out of 26 instances with sarcomas and eight of 15 instances of carcinomas. Of the 37 patients with a solitary metastasis detected on roentgenograms of the chest, 22 were found to have additional lesions on the tomograms, 11 of 16 sarcomas and 11 of 21 carcinomas. At thoracotomy, however, nine of ten patients with a single metastasis from sarcomas were found to have even more lesions, while, in patients with carcinomas, tomograms were found to be accurate. Routinely, prior to major ablative operations for sarcomas and before excision of pulmonary metastases, it is suggested that tomography be carried out.

Adolescent↗
PubMed1976

Progestational agents and blood coagulation. VII. Thromboembolic and other complications of oral contraceptive therapy in relationship to pretreatment levels of blood coagulation factors: summary report of a ten-year study.

During a ten-year period, 348 women were studied for a total of 5,877 patient months in four separate studies relating oral contraceptives to changes in hematologic parameters. Significant increases in certain factors of the blood coagulation and fibrinolysin systems (factors I,II,VII,VIII,IX, and X and plasminogen) were observed in the treated groups. Severe complications developed in four patients. All four had an abnormal blood coagulation profile, suggesting "hypercoagulability" before initiation of therapy. Some of these findings represented the most extreme abnormalities seen in the entire group of patients; some increased further during therapy. One of these patients developed a myocardial infarction before receiving any medication, shortly after the base-line values were obtained. One patient developed retinopathy 19 months after she began therapy, and another developed thrombophlebitis after 27 months of therapy. The fourth patient developed thrombophlebitis 14 days after initiation of contraceptive therapy. All four patients were of the A or AB blood group. Previous studies suggested the possiblility of increased propensity for thromboembolic episodes in patients possessing the A antigen. It appears from these data that hematologic work-ups may be useful in women who are about to start long-term oral contraceptive therapy.

Adult↗
PubMed1976

Studies and characterization of a murine neuroblastoma model.

Clinical chemotherapy in the treatment of neuroblastoma is undergoing further evaluation. Chemotherapeutic agents, cyclophosphamide, vincristine, and hexamethylmelamine, were investigated in a murine neuroblastoma model that, in part, histologically and morphologically resembles the human tumor. The tumor was inoculated subcutaneously (SC), intramuscularly (IM), intraperitoneally (IP), intrarenally (IR). Growth of tumor was observed at all sites, as well as the appearance of metastases. Maximal survival of 32 +/- 1 days was seen (SC) and the minimum was 15 +/- 1 days (IR) (p less than 0.05). Corresponding survival rate for IM was 26 +/- 1 days and IP 21 +/- 1 days. For this reason SC was selected for drug testing. Cyclophosphamide 100 mg/kg/week showed the most favorable results, as determined by autopsy status with fewer tumors and a greater tumor weight decrease over time. This agent also showed a significantly longer survival in comparison to all other drugs (p less than 0.0001). The results with vincristine and hexamethylmelamine in the dose ranges employed differed little from the placebo, except for the finding of a slight decrease in body weight at autopsy.

Altretamine↗
PubMed1976

Serum ribonuclease in patients with lung carcinoma.

Fifty-one previously untreated cases of lung carcinoma and 7 normal healthy controls were evaluated with respect to serum ribonuclease (S-RNase) levels. Cellular immunity was tested in 22 of these 51 cases by leukocyte migration inhibition test (MIT) using extract of culture cell line of lung carcinoma. S-RNase levels in lung carcinomas were significantly elevated. There appeared to be no difference in S-RNase levels by histological classification. More striking was high S-RNase level in disseminated versus localized cases. MIT results indicated impairment of cellular immunity in those cases of more elevated S-RNase. S-RNase may be implicated in blocking phenomenon associated with neoplastic disease.

Adenocarcinoma↗
PubMed1976

Treatment, results and prognostic factors in stage I and II sarcomas of the corpus uteri.

One-hundred and four cases of Stage I and II uterine sarcomas treated at Rosewell Park Memorial Institute over a 27 year period are reviewed. Included are 30 cases of mixed mesodermal tumor, 27 cases of carcinosarcoma, 25 cases of endometrial stromal sarcoma, and 22 cases of leiomyosarcoma. Prognostic factors were found to include histologic classification, stage, uterine size, depth of myometrial invasion, and type of treatment. Endometrial stromal sarcomas had the best over-all prognosis. Radiation therapy alone was inadequate treatment, but was of adjunctive value to surgery in terms of increasing survival and decreasing pelvic recurrences in patients with endometrial stromal sarcoma, mixed mesodermal tumor, and carcinosarcoma. Patients with leiomyosarcoma did not benefit from adjunctive radiation therapy.

Adult↗
PubMed1976

Hormones in renal cancer.

Plasma renin, erythropoietin and chorionic gonadotropin levels were evaluated in 57 patients with renal adenocarcinoma. Renin elevation, found in 37 per cent, was unrelated to blood pressure levels but was associated with high grade, high stage lesions of mixed histologic cell type and predicted a poor prognosis. Erythropoietin was raised in 63 per cent of patients and was more sensitive than renin in indicating the presence of renal adenocarcinoma. However, it was less specific and did not correlate directly with tumor grade, stage, histologic type, prognosis or hematocrit and hemoglobin levels. None of the patients had elevated chorionic gonadotropin levels. Therefore, we believe that renin and erythropoietin determinations may be of value as biochemical tumor markers in renal adenocarcinoma.

Adenocarcinoma↗
PubMed1975

End results of radiation therapy, alone and combination with 5-fluorouracil in colorectal cancers.

The authors retrospectively analyzed the results of irradiation in 148 cases of primary inoperable and recurrent adenocarcinoma of the colon and rectum treated at the Department of Radiation Therapy, Roswell Park Memorial Institute between 1962 and 1970. This group includes 95 recurrences and 53 inoperable primaries. Uninterrupted radiotherapy was used in 118 cases and split-course technique in 30 cases. Eleven patients received combined radiotherapy and surgery. Seventy-eight patients received a combination of 5-fluorouracil (5-FU) and irradiation. The response rate and survival of individual groups is discussed in detail. This study indicated that perineal recurrences should receive whole pelvic irradiation in addition to perineum field. Split-course technique appeared to yield a better survival than the uninterrupted course. The best 5-year survival rate (64%) is found in the group treated with a combination of radiation and surgery. For locally advanced, inoperable cancers, split-course technique, combined 5-FU and irradiation gave the best results, achieving longer palliation with improved quality of life and sometimes yielding cure (5-year survival).

Colonic Neoplasms↗
PubMed1975

Prognosis of bladder carcinoma in patients treated with cystectomy.

Prognostic criteria for bladder tumors are the stage and grade of the tumor in the present series of 82 patients, in which all patients received the same treatment. These criteria are related and the combined evaluation increases the prognostic accuracy for the disease. In addition, the diameter and not the number of bladder tumors on primary diagnosis is an important prognostic sign. A significant number of tumors at the first clinical evaluation were apparently understaged and undergraded and to a lesser degree overstaged and overgraded as compared with cystectomy specimen evaluations. Despite the total cystectomy, even the patients with superficial bladder lesions, a significant number died from the bladder tumor and 1/4 of the patients had metastases at post mortem examination. The 5 year overall survival with total cystectomy was 40% and for 10 years 15%. Other adjuvant forms of therapy pre- and post-operatively must be assessed.

Adult↗
PubMed1975

Urinary gonadotropins in management and prognosis of testicular tumor.

Ninety-three cases of germinal testicular tumors with urinary gonadotropin (HCG) values, estimated by biologic or radioimmunoassay techniques, were reviewed. Preoperative values of HCG and subsequent postoperative values were related to response to treatment and prognosis. Twenty-five patients (26.9 per cent) comprised the seminoma group, and 68 patients (73.1 per cent) the nonseminomatous groups of germinal neoplasms. High HCG values were observed in the nonseminomatous group pre- and postoperatively by both assay procedures. Most significant was the high HCG values postoperatively (p smaller than 0.05, x2 equals 5.21 and p smaller than 0.05, x2 equals 5.23) for the biologic assay and radioimmunoassay, respectively, with high HCG values being associated with a poor cumulative 24 per cent two-year survival rate. Urinary HCG assay is of prognostic value in the ongoing management of testicular neoplasms. In the future, serum HCG assays may be of additional benefit.

Adolescent↗
PubMed1975

Secondary carcinomas of the kidney.

We reviewed 81 cases of secondary carcinoma of the kidney, the clinical detection of which still remains a challenge. All lymphomas were excluded from this study. There was no direct relationship of the cell type of the primary tumor to the degree of renal invasion. Generally, functional renal impairment was not a significant entity unless renal destruction was extreme. Ureteral obstruction was infrequent in this group. Angiography was helpful in determining the metastatic spread as well as the degree of renal involvement. The varied aspects of the primary tumor's pathophysiology have been a continuing challenge to early detection and successful therapy in any patient. Furthermore, the anatomic location and the peculiar biologic behavior of some primary tumors may make the clinical course and response to treatment unpredictable. Lungs, stomach, breast and contralateral kidney remain the common primary sources of malignancy likely to metastasize to the kidney, with an apparent period of occult growth and further metastases before symptoms appear, The possible delay in seeking medical attention, that is chemotherapy and radiation, as well as the aggressiveness of the primary tumor itself may contribute to the poor survival noted in this study despite the use of various therapeutic modalities.

Adolescent↗
PubMed1975

Evaluation of biological markers in bladder cancer.

The value of biological markers of bladder cancer was studied in 66 patients. The markers included serum and urine carcinoembryonic antigens, serum and urine fibrinogen degradation products, total lymphocyte counts, urine lymphocytes and urine cytology. A high degree of accuracy (90 per cent) was found in correlating cytology and urinary fibrinogen degradation products with the activity of the disease. Serum and urine carcinoembryonic antigens, serum fibrinogen degradation products, total lymphocyte counts and urine lymphocytes were found to have no value in screening bladder cancer patients. Urinary fibrinogen degradation products and cytology in combination are recommended for screening and followup of patients at high risk.

Carcinoembryonic Antigen↗
PubMed1975

Effects of iproniazid, chlorpromazine and methiothepin on DMT-induced changes in body temperature, pupillary dilatation, blood pressure and EEG in the rabbit.

The effects of i.v. N,N-dimethyltryptamine (DMT) were studied on arterial blood pressure, rectal temperature, pupil size and the electroencephalogram of the rabbit. DMT altered these parameters in a dose-related manner causing increased blood pressure, hyperthermia, pupilary mydriasis and activation of the electroencephalogram. Pretreatment with the monoamine oxidase inhibitor, iproniazid, prolonged the effects of DMT, while pretreatment with chlorpromazine or methiothepin attenuated these actions of DMT.

Animals↗
PubMed1975

Thromboembolic complications of oral contraceptive therapy.

During a ten-year period, 348 women were studied for a total of 5877 patient months for changes in hematologic parameters induced by oral contraceptives. Significant increases were observed in Factors I, II, VII, VIII, IX, X and plasminogen. Severe complications developed in four patients. All four had an abnormal blood coagulation profile, suggesting "hypercoagulability" before initiation of therapy. All four patients were of A or AB blood group. It appears from these data that hematologic workups may be useful in women who are about to embark on long-term oral contraceptive therapy.

Blood Cell Count↗
PubMed1975

Central anticholinergic actions of doxepin in rabbits.

Neuropharmacological effects of doxepin were studied in rabbits to reveal fundamental actions which might explain its clinical efficacy. The results indicate that central effects of this compound are similar to those reported for atropine and the tricyclic antidepressants. In this regard, doxepin produced mydriasis and EEG synchrony without producing overt signs of sleep. It inhibited in a dose-related manner the EEG activation produced by physostigmine. It inhibited the EEG, but not behavioral, effects of methamphetamine. Doxepin enhanced some of the behavioral effects of methamphetamine, as does atropine.

Animals↗